Comparative Effectiveness and Safety of FOLFOXIRI Plus Cetuximab Versus FOLFOXIRI Plus Bevacizumab in Metastatic Colorectal Cancer: A GRADE-assessed Systematic Review and Meta-analysis

Metastatic colorectal cancer (mCRC) is a leading cause of cancer-related mortality worldwide. FOLFOXIRI combined with targeted agents has shown promising outcomes in mCRC. This meta-analysis compares efficacy and safety of FOLFOXIRI plus cetuximab versus FOLFOXIRI plus bevacizumab in patients with mCRC.

A literature search was conducted across PubMed, Cochrane, Embase, Scopus, and clinicaltrials.gov until February 2025. Analysis was performed using RStudio v4.5.0. Pooled estimates are reported as hazard ratios, odds ratios, risk ratios, and mean difference with 95% CIs using random-effects model. Heterogeneity was assessed using I² statistics.